Headaches

What are Headaches and What Can You Do About Them?

Not all are aware that there is a medical term for headaches, and that is called “cephalalgia.” Regardless of what it is called, it is referred to as a continuous pain in the head and neck area of the person. When you feel a pulsing, throbbing, or stabbing pain in the front, center, or rear parts of your head, you are usually feeling headache symptoms. Headaches are usually experienced in pain-sensitive areas around the head and neck which include the blood vessels, nerves, and muscles. The intensity of the pain ranges from mild, tolerable, to severe and may be experienced occasionally, recurrently, or persistently (aka chronic) which can all be treated and prevented.

An expert in the field of Orofacial Pain and with impeccable credentials, Dr. Katayoun Omrani of Headache TMJ Los Angeles Pain Clinic provides the best treatment services for patients suffering from mixed headaches. Why suffer the nagging pain when you can treat headaches and prevent them with the help from the Headache TMJ Los Angeles Pain Clinic? Give us a call today at (310) 422-4246 for a hassle-free appointment booking.

Headache Treatments

There are over 150 types of headaches but the majority of people who experience headaches suffer from one of the primary types according to the ICHD or the International Classification of Headache Disorder.

Types of Headaches

The primary types of headaches that most people experience fall under:

• Tension Headaches
• Cluster Headaches
• Migraines

These types of headaches have different symptoms and causes that therefore require different types of treatment and medication, which makes it crucial for one to know what triggers it and what is the most suitable treatment for it.

Tension Type Headaches

Tension-type headaches are signified with muscle tightness, especially on the specific parts of the head, neck, and scalp. People who suffer from this type of headache mostly feel:

• A tight band of pain around the head and a dull ache or pressure
• Mild to moderate pain on both sides of the head

Tension headaches fall under one of these 2 categories:

• Episodic: Episodic attacks are more sporadic and generally last a couple hours and sometimes can last up to several days.
• Chronic: Chronic attacks occur when headaches happen 15 days or more in a month for several months.

Tension Headache Treatments

There are several headache treatment options available for tension headaches:

Cognitive behavioral therapy – These therapies include relaxation training and stress coping training to help reduce stress and anxiety.

Biofeedback therapy – Biofeedback tracks your body’s functions like heartrate, respiration, and brain activity to provide you with information that you can use to help reduce stress and eliminate tension headache triggers.

Massage therapy – Massages can help reduce stress and tension while relieving tight muscles that cause tension headaches.

Acupuncture – This method inserts needles into pressure points that can stimulate your circulation system and immune response which help relieve tension headaches.

Physical Therapy – Tension headaches can sometimes be caused by unnecessary strain on certain muscle groups which can be treated with physical therapy.

TMJD Treatments – In patients who present with comorbid headaches and TMD, both disorders should be treated together but separately. TMD treatment includes patient education, self-care, behavioral therapy, pharmacologic interventions, appliance therapy and physical therapies including trigger point injections and TMJ injection.

Exercise – Certain types of exercise like yoga and tai chi have the benefit of focusing your attention, reducing stress, stretching muscles, and releasing endorphins which can all help alleviate the symptoms of a tension headache.

Tension Headache Medications for Relief

The occasional tension-type headache is easily treated with over-the-counter medications such as:

• Aspirin
• Ibuprofen: Advil & Motrin
• Acetaminophen: Tylenol
• Naproxen

Tension Headache Preventative Medications

To manage and prevent the pain from chronic tension-type headaches, it is best to take daily prescription medications, such as:

• Antidepressants: Tricyclic antidepressants like Nortriptyline and Amitriptyline or SNRIs like Effexor and Cymbalta
• Anticonvulsants: Gabapentin, Lyrica, & Topamax
• Muscle relaxers: Flexeril, Zanaflex, Skelaxin, Robaxin, & Baclofen

Cluster Type Headaches

Cluster headaches are described as intense pain in or around one eye on one side of the head and occur at intervals for weeks to months. People who suffer from this type of headache often feel:

• Nausea
• Tearing
• Nasal congestion
• Nasal discharge

Cluster Headache Treatments

• Pure oxygen therapy – Inhaling pure oxygen through a mask alleviates much of the symptoms of cluster headaches relatively quickly.
• Noninvasive vagus nerve stimulation (VNS) – VNS uses a small controller to electrically stimulate the vagus nerve. Some studies have found that this therapy helps reduce the frequency of cluster headaches.
• Surgery – There are surgical routes that implant neurostimulators in your brain that are designed to help with cluster headaches. Occipital nerve stimulation and deep brain stimulation have both shown promising results treating cluster headache symptoms. Both of these options should be done only after all other treatment options have failed because they are invasive and come with risks like infection and hemorrhage.

Cluster Headache Medications for Relief

Over-the-counter pain relievers do not usually help relieve discomfort for cluster headaches, instead, medications such as the following are more effective against cluster headaches:

• Triptans, including Sumatriptan and Zolmitriptan
• Dihydroergotamine
• Narcotics (only with strict compliance since it is habit-forming)
• Octreotide
• Lidocaine & other local anesthetics
• Lithium Carbonate

Cluster Headache Preventative Medications

Preventive medications for cluster headaches include:

• Calcium channel blockers
• Corticosteroids
• Antiepileptic medication: Divalproex

Migraines

Migraines affect three times more women than men and are considered to be the most common type of headaches. Migraines naturally:

• cause moderate to severe pain
• throbbing
• cause nausea, vomiting, or being sensitive to light or sound
• can be felt only on one side of your head, but some instances on both sides
• aggravates with activity such as walking or climbing up the stairs
• can last from 4 to 72 hours without treatment

Treatment for migraines is similar to that of headaches so following many of the tips for headache relief should help alleviate migraines as well.

Home Remedies & Tips to Get Rid of Headaches

When headaches happen there are several remedies to ease the pain even without having to go to a doctor. However, these are only advisable for headaches with tolerable pain level and occurs due to circumstances that are not frequent. If you have a headache, try the following tips and home remedies to help soothe the pain.

• Using a cold pack

For migraines, place something cold on your forehead. A cold pack can simply be from some ice cubes wrapped in a towelette or a reusable compress bag that can either be submerged in cold water or put in a freezer for a few minutes. Keep the cold pack on your forehead for 15 minutes and off for another 15 minutes to take a break. Do this until the headache is relieved.

• Using a hot pack

For a tension-type headache, place a hot pack on your nape. It can be in the form of a towelette damped with warm water or a reusable compress bag submerged in hot/warm water or put on a microwave for a couple of minutes. Always be cautious in using a hot compress, since it may cause burns due to miscalculated heat and prolonged use.

• Ease pressure on your head

Any tight compression on your head may cause a headache. For example, wearing your hair in a tight ponytail, using a tight-fit hat, and the like. Avoid, if possible, any tight compression on your head by simply using the right size or by easing the pressure by taking it off.

• Dim the lights

Long exposure to bright light, like from a ring light or your computer and cellphone screen, can cause a headache. You can avoid such exposure by wearing protective eyeglasses, such as sunglasses when outdoors or anti-glare or blue-light protected eyeglasses when using your computer or cellphone. Using daylight-spectrum bulbs in your light fixture or simply setting your lights to dim would help ease your headache.

• Chew in moderation

Chewing involves the movements of the jaw and grinding of the teeth that need to be done to process food. If this is done excessively, like prolonged chewing on a piece of gum, eating crunchy and sticky foods, biting into a frozen popsicle and the like can definitely cause a headache. Chew in moderation and in small bites to prevent any pain that can trigger a headache.

• Drink lots of water

Being dehydrated can lead to a headache or make one worse. Make sure to drink lots of water to keep hydrated, some people need 4 to 6 glasses of water per day, and some need more or even less.

• Chill and relax

The usual trigger for a headache is stress and the best remedy for it is to breathe, chill, and relax. Whatever method it may be, yoga, meditation, muscle relaxation, and the like, practicing how to chill and relax while you are experiencing a headache can help soothe the pain. The more relaxed you are the more your nerves and breathing normalize and regulates good blood flow.

• Take Melatonin

Melatonin is a hormone that has been identified as deficient in migraine patients. Studies have shown positive results after taking melatonin supplements to help prevent the frequency of headaches.

• Exercise Often & Consistently

Doing normal exercise helps reduce tension and releases endorphins that suppress headache pain. Check with your doctor about the optimal level of activity to stay healthy and be sure to warm up before working out. Don’t overexert yourself though because there is a chance that being dehydrated and fatigued could exacerbate headache symptoms if the workout is too strenuous. Consistent exercise will help maintain healthy body functions and weight which reduce the chances of headaches.

• Take medications in moderation

Over-the-counter pain relievers are well within reach in every pharmacy or store and can be a convenient way to ease the pain from a headache. However, taking such medications frequently may cause more damage than just as a remedy. To avoid medication overuse headaches, follow the directions on the label for each medication and these guidelines:

• Choose liquid over pills since it is absorbed by the body faster
• Abstain taking NSAIDs or anti-inflammatory drugs like ibuprofen and naproxen
• Take the medication as soon as you feel the pain for a chance to soothe it with a smaller dose rather than the latter
• Be sure to talk to consult a doctor when the headache still persists even after taking the medications.

Why Do I Have a Headache?

Headaches are an extremely common health issue characterized as continuous pain in the head and neck area. Headaches are categorized as either primary or secondary, according to the International Headache Society (IHS), and can have varied causes.

Primary Headache Causes

A primary headache results from problems involving the structures of the head and neck and is not a symptom of an underlying illness. Different types of primary headaches may be due to the excessive activity in or around:

• Blood vessels
• Muscles
• Nerves
• Brain chemicals
• Specific areas of the brain

Secondary Headache Causes

A secondary headache is a symptom of an underlying medical condition, such as:

• Pregnancy
• Infections
• Hypothyroidism
• TMJ (temporomandibular joint) Disorder
• Stroke
• Brain tumor

Secondary headaches are often indicators of serious health issues, so it is important to seek medical advice for any headache that:

• Does not get better after treatment or medication
• Occurs with symptoms like confusion, memory loss, change in perception, or neck stiffness
• Is painful and frequent enough to disrupt day to day activity
• Is persistent and does not go away after several days

Headache Triggers

Headaches, minor or severe, are both unpleasant to feel especially if on a daily basis. This is why knowing what triggers your headaches is a big source of relief. Taking notes or keeping a journal to track what triggers your headaches, such as when it happened, what did you eat, where did it happen, and so on, can help you prevent the onset of a headache. Below are what usually triggers a headache:

• Stress: Stress usually leads to a tension headache, which causes tight muscles in the shoulders and neck and would make you feel that you have a tight band around your head. Stress is also a common trigger for migraines, which causes throbbing pain on one side of the head and sensitivity to light and sound that can last for hours or days.
• Depression / Anxiety: Extreme worry, fear, or depression increases stress hormones which can increase the likelihood of tension headaches.
• Bad Posture / Sedentary Lifestyle: Sitting down with a bad posture for long periods of time without interruption can put strain on shoulder, back, and neck muscles. This muscle strain can lead to tension headaches.
• Diet: Diet has a significant impact on fueling your body with the right nutrient to function properly. Skipping meals can deprive you of certain thing your body needs while eating an excessive amount of certain foods can trigger a headache. Foods like:

• • Aged cheese (blue cheese, brie, cheddar, etc.)
  • Alcohol (red wine, whiskey, beer, scotch, and champagne)
  • Caffeinated beverages
  • Peanuts, peanut butter, almonds, etc.
  • Tomato-based products
  • Preserved or pickled foods (pickles, olives, sauerkraut, etc.)
  • Wheat-based foods (bread, crackers, etc.)
  • Most variety of beans (peas, snow peas, lentils, etc.)
  • Certain fresh fruits (avocados, papaya, citrus fruits, etc.)
  • MSG (monosodium glutamate) can usually be seen in packed seasonings
  • Dairy products
  • Canned and processed foods
• Environment: Factors such as bright light, smoke, fog, humidity, intense scents, cold weather are but just a few that can trigger a headache. Some may even relate their headaches depending on the season, like spring or fall, which highly causes allergic rhinitis that can be associated with headaches.
• Hormones: Women experience changes in estrogen levels which can cause migraines. Due to this trigger women suffer from migraines more often than men. However, in some instances, men who take estrogen therapy may suffer migraines too because of the varying estrogen levels.
• Caffeine Withdrawal: This can trigger a migraine since your body would have to adapt abruptly from the loss of caffeine in your system. Caffeine causes the blood vessels to constrict and without it, the blood vessel would widen and bulge out with each heartbeat which causes the pounding pain of headaches.
• Lack of Sleep: Not sleeping triggers migraines and tension headaches. Being sleep-deprived reduces the body’s pain threshold, thus making it prone to headaches.
• Dehydration: The body functions optimally when it is well hydrated and full of micro and macro minerals and vitamins needed to help regulate the body. Your body loses these minerals when you sweat or urinate them out which means that your body’s water and electrolytes need to be replenished otherwise you risk triggering a headache.

Are Headaches Hereditary?

Headaches that are hereditary are usually familial hemiplegic migraines. Generally, someone who has hereditary migraines has at least one parent with them as well. While having a parent with familial hemiplegic migraines does not guarantee a child will, they are 4 times more likely to have them too. Other than inheriting the headache, it can be triggered as well by environmental factors shared in a family’s household or environment.

Symptoms of Headaches

Constant pain from headaches can greatly affect a person’s well-being that can cause negative and unhealthy outcomes. Recognizing the signs of headache can help avoid such outcomes, although, the symptoms usually vary according to their type, below are common factors that indicate headaches:

Tension-type Headache Symptoms

Unlike migraine symptoms, tension-type headaches do not involve nervous system disturbances, nausea, or vomiting. Rather, tension headaches are characterized with:

• Dull and aching head pain
• Tightness & pressure on the forehead or on the sides and back of the head
• Muscle soreness on the neck, scalp, and shoulders
• Irritability
• Difficulty concentrating
• Trouble sleeping

Cluster Headache Symptoms

This type of headache can happen without warning. It is characterized with:

• Sharp, intense pain
• Located in or around any one eye
• May also affect other areas of the sufferer’s face, neck, and shoulders
• Pain is usually felt on either side of the head
• The eye where the pain is felt is usually watery and tearful, with some redness and swelling around it
• Clogged nose and sinus pressure on the pain side may also occur.

Cluster headaches usually occur every day, and at times several times a day. One single episode may last from 15 minutes to 3 hours, with the majority of them occurring during the night, about an hour or two before bedtime. The feeling of exhaustion sets in after every attack.

Can Headaches Be Prevented?

Here are some of the ways on how people can manage and prevent the pain brought about by headaches:

• Quit smoking.
  Smoking is indeed dangerous for one’s health. Apart from the obvious effects of doing this vice, smoking can trigger headaches, especially cluster headaches. Even non-smokers whom are often exposed to secondhand smoke may experience headaches as well. Sufferers can ask their doctors about community programs that help reach out to smokers who want to cease their bad habits.
• Drinking less or eliminating alcohol.
  There is no harm in drinking alcohol, as long as it is taken in moderation. People who already determine alcohol as the primary source of their headaches have the option to drink less or eliminate alcohol completely in their systems.
• Exercise.
  The feeling of sluggishness brought about by lack of inactivity can trigger headaches. Spicing things up by becoming active through exercise can help reduce the pain brought by the condition. However, extreme levels of activity may cause muscle strain, which would then cause headaches. Keep exercise routines manageable. It is often advised that one must get 20 minutes of exercise thrice a week.
• Losing weight.
  Headaches are often linked to people who are either overweight or obese. Increased activity, healthy eating habits, and generally living a healthy lifestyle, can help lessen the frequency of headaches.
• Improving posture.
  Standing, walking, and sitting in a correct position always matters. A person who has poor posture may experience muscle strain, which is always associated with headaches. Improving one’s posture while sitting on a computer chair at work or while driving a car, as well as standing correctly, can prevent recurrence of headaches.

Headache Diagnosis Information

Due to the high costs of medical consultation and treatment with a doctor, people tend to self-medicate and make their situation and suffering even worse. It may be costly but it is always the best option to treat the suffering you feel from your headaches when you consult a doctor. Your doctor would usually prescribe a physical examination, discuss your medical history and headache symptoms. For a headache evaluation, your doctor would ask the following:

• The description of your headache: which area do you feel pain, the level of pain you feel, the frequency of when you have the headache, when you usually feel the headache, how long does your headache last, etc.
• What are the foods, drinks, or changes that trigger your headache?
• What events or activities could be potentially triggering headaches?
• What is the stress level that you are currently experiencing?
• What is your sleep routine?
• How long has it been since you first started getting headaches?
• Who else in your family is experiencing headaches?
• How much caffeine is consumed daily?
• Were there any warning signs of blind spots, changes in vision, or bright lights prior to the headache?
• Are there any other symptoms like sensitivity to light and noise, change in appetite, or behavior?
• Any previous history of headache treatment?

These are but just a few of the questions that your doctor might ask during your headache evaluation along with your performance at work, family background, and medical history to pinpoint the type of headache you have and to have a final diagnosis.

After finishing the discovery phase of the exam, your doctor will move onto physical and neurological examinations. These exams will try and find symptoms of underlying sickness or abnormality that may be causing headaches. These symptoms can include:

• Fatigue
• Muscle weakness or numbness
• Equilibrium problems
• Vision problems
• Confusion
• Fever
• High blood pressure
• Seizures
• Nausea

In a circumstance that your condition is unusual, complex, and severe, the tests to rule other causes for your pain might include having an:

• MRI (magnetic resonance imaging): An MRI uses radio waves and a strong magnetic field to produce imagery of the brain and connecting blood vessels. MRIs can help diagnose abnormalities like growths, tumors, bleeding, clots, strokes, infections, and other neurological conditions.
• CT Scan (computerized tomography scan): CT scans piece together a series of X rays to assemble a digital cross-sectional image of the head and brain. This also helps identify abnormalities like tumors, infections, swelling, damage, and bleeding.

When to Call Your Doctor About Headaches

If your headache pain still persists for several days even after taking pain relievers, Health.harvard.ed states that it is best to seek consultation with a doctor. However, if you have any of the following headache symptoms stated below, you should get medical care right away.

• A headache right after sustaining a head injury
• A headache together with nausea and vomiting
• A headache that onset with other neurological symptoms like weakness, dizziness, paralysis, speech difficulty, confusion, seizures, and change in vision and personality
• A headache that came suddenly and severely
• A headache with fever, shortness of breath, stiff neck, or rash
• A headache that occurs three or more times a week
• A headache that keeps getting worse and severe
• A headache that is triggered each time you cough, bend, or from a strenuous activity like jogging or exercise
• A headache so painful that it wakes you during sleep
• Any new headaches that are unfamiliar in symptoms or severity after the age of 55

Preparing for Your Headache Appointment

Once you have an appointment to see a doctor about your headache it would be helpful to have the following information with you:

• A headache journal to keep track of details of your headache including symptoms, timing, duration, severity, and triggers will serve as a reference for your doctor.
• A note with your personal information, including major events and changes in your life that brought about either stress or excitement.
• A list of all the medications and remedies you did to ease your headache, along with your daily supplements like herbal tea or vitamins.
• A note of what you would like to ask your doctor about your headache.

Contact a Headache Doctor to Schedule an Appointment Today

If you or a loved one are experiencing abnormally severe headaches and are interested in treatment options, call the Headache TMJ Los Angeles Pain Clinic to schedule an appointment to see Dr. Kathy Omrani at (310) 422 – 4246.